In this article the authors present historical evidence that Black patients with organic brain syndromes (OBS) associated with alcoholism are often incorrectly diagnosed as schizophrenic. Case histories of patients with OBS associated with alcoholism who have been diagnosed as schizophrenic are presented. Factors responsible for the misdiagnosis of Blacks with OBS associated with alcoholism are then discussed. Neurochemical evidence is given to support the contention that chronic alcoholism can cause chronic neurochemical brain dysfunction resulting in a psychiatric disorder that imitates schizophrenia. Finally, the treatment implications of misdiagnosis are discussed with emphasis on how misdiagnosis of alcohol-related OBS results in mistreatment and thus a poor outcome for the Black alcoholic patient.